If you build it, they will learn: A review of models in veterinary surgical education

Development and Validation of a Bovine Left Displaced Abomasum Reduction Model and Rubric

Left displaced abomasum (LDA) is a common condition in dairy cattle where the abomasum dilates and migrates to the left side of the abdomen. This condition causes significant economic losses for farmers and can result in life-threatening complications, so it is critical that veterinary students be taught to surgically correct a LDA before graduating and entering food animal practice. Models have been successfully used to teach students to perform other surgical procedures, but limited models exist to teach surgical skills to prospective dairy veterinary students. This study sought to develop and validate a bovine LDA reduction model and scoring rubric using a validity framework consisting of content evidence (expert opinion), internal structure evidence (reliability of rubric scores), and evidence showing the relationship with other variables (comparing expert to novice performance). Experienced veterinarians (n = 12) and novice veterinary students (n = 30) surgically deflated and reduced the model's LDA while being recorded. Videos were scored by a blinded expert. Participants completed a survey afterward. All veterinarians reported that the model was suitable for use in teaching and assessing students, offering content evidence for validation. Scores produced by the checklist had good reliability (α = .886), offering internal structure evidence. Veterinarians achieved higher checklist (p = .025) and global rating scores (p = .005) than students, offering relationship with other variables evidence. The development and use of food animal models promotes students' development of competence in performing food animal procedures, leading to better qualified new graduates entering food animal practice. The use of models also protects animal welfare during students' training.

Can a Simple Model Have Value without Validation? A Study to Develop and (Attempt to) Validate a Bovine Caudal Epidural Model and Rubric

Bovine practitioners expect new graduates entering clinical practice to be able to place a caudal epidural. Teaching this task on models facilitates scheduled training sessions and sufficient practice to reach competency. This study sought to create and validate a bovine caudal epidural model and scoring rubric using a framework of content evidence, internal structure evidence, and relationship with other variables evidence. Veterinarians (n = 11) and students (n = 40) were video recorded while placing a caudal epidural on the model. Recordings were scored by a blinded rater. Participants completed a survey evaluating the model's features, ease of use, and anticipated best use. Veterinarians reported that the model was helpful for students to learn and practice the task and that the model had sufficient landmark features and realism (content evidence). Rubric scores achieved acceptable internal consistency after one item was dropped (α = .736; internal structure evidence), and there was no significant difference between veterinarians' and students' performance scores on the model (relationship with other variables evidence). Survey feedback indicated the task on the model was simple, allowing students to achieve scores similar to those of veterinarians. Therefore, the model and rubric were not able to be validated using this study's validity framework. However, there are simple clinical skills models used in veterinary education and other health care fields, and research suggests that learning does take place on these models. Educators must consider whether simple models that are helpful for students to practice their skills may still have value, even if they are not able to be validated.

Teaching experience, not surgical residency training, is the critical factor in optimizing student learning outcomes in performing ovariohysterectomy on a model

OBJECTIVE

To determine if surgical skills instructors' experience and qualifications influence students' learning of small animal ovariohysterectomy on a model (mOVH).

SAMPLE POPULATION

Second-year veterinary students (n = 105).

METHODS

Students were randomized to three groups, taught by: (1) residency-trained surgeons with over 3 years' experience teaching mOVH, (2) general practitioners with over 3 years' experience teaching mOVH (GP >3), and (3) general practitioners with under 3 years' experience (GP <3). Students completed four 3-h laboratories where they performed mOVH under the supervision of one of the three types of instructors. Students were assessed performing mOVH using a validated 22-item rubric and completed a survey about their experience.

RESULTS

GP <3 group students achieved lower total rubric scores than GP >3 group students (p = .021). Surgeon-taught students' scores did not differ from those taught by GP >3 (p = .685) or GP <3 (p = .052). GP <3 group students were more likely to require remediation than those taught by surgeons (p = .001); there were no differences between the other groups (surgeons vs. GP >3 p = .44; GP <3 vs. GP >3 p = .11). Students reported similar satisfaction with their instruction. Instructors with over 3 years' experience teaching mOVH had better student learning outcomes compared to instructors with under 3 years of experience. While mOVH teaching experience did influence learning, the instructor's completion of a surgical residency did not.

CONCLUSION

The results of the study indicate a need for more extensive training for new surgical skills instructors and demonstrates that GPs with experience teaching surgical skills are suitable instructors for teaching ovariohysterectomy on a model.

CLINICAL RELEVANCE

This study indicates a need for more extensive training for new surgical skills instructors and demonstrates that GPs with experience teaching surgical skills are suitable instructors for teaching ovariohysterectomy on a model.

Evaluation of a Training Model to Teach Skills Associated with Esophagostomy Tube Placement in Companion Animals

Models and simulations are used in veterinary education to allow students to practice surgical skills in order to obtain clinical competence. Further development of models is also driven by the requirement of veterinary institutions to reduce the use of animal patients in teaching (live or cadaver). Esophagostomy tube placement is a common therapeutic procedure performed in companion animal critical care cases, and a model was developed to help teach this skill. Validity evidence was collected and analyzed to evaluate this model at the University of Surrey. Veterinarians (n = 14) provided content validity evidence on using the model, and students (n = 19) provided further construct evidence. Students were taught the skill on either a model or a cadaver. These students were then assessed on a cadaver the following week. Global rating scales were used as a measure of performance, and data were recorded on confidence ratings after both teaching and assessment. Comparisons of the global rating scales and confidence levels were evaluated for both the model and cadaver-taught groups. There were no statistical differences in the performance data or confidence levels of the two groups. Most of the veterinarians believed the model was easy to use (13/14), had realistic landmarks (11/14), and was a suitable alternative to learning the skill than in the animal patient (12/14). The esophagostomy tube model is a low-cost easy-to-make alternative to help teach aspects of this skill before performing on an animal patient.

Development and Validation of a Uterine Prolapse, Epidural, and Vaginal Suture Model

Uterine prolapses sporadically present to bovine practitioners. Exposing veterinary students to this is challenging due to the inability to replicate a live animal prolapses in a teaching environment. The objective of this study was to develop a model that represents each step of the process of correcting a uterine prolapse and to perform a validation study of the model and rubric used to score performance using a skill comparison between experienced veterinarians and novices (students). The model was designed and built, and 27 students and 18 bovine veterinarians were recruited to participate in the evaluation of this model. Each participant performed each step of the model while being video recorded. Following model use, all participants completed a survey on their prior experiences and opinions of the model. Videos were viewed, and performances scored by one author using a rubric. Opinions on the model were mostly favorable in regard to use and realistic experience. There was no significant difference between the scores of veterinarians and veterinary students. However, there was an association with an excellent level of global rating scores for veterinarians while the veterinary student participants were associated with borderline satisfactory to good competency levels except for the epidural. There was a statistically significant association between the global rating scores and the check list competency levels. The lack of significant difference may be attributed to students previous experiences Based on feedback from the survey responses, the model will be used in clinical skills labs to provide experience in this area.

Development and Validation of an Equine Castration Model and Rubric

Castration is one of the most common surgeries performed in equine practice. Veterinary students require deliberate practice to reach competence in surgical procedures including equine castration, but availability of patients limits students' practice opportunities. A recumbent equine castration model was created and evaluated using a validation framework consisting of content evidence (expert opinion), internal structure evidence (reliability of scores produced by the accompanying rubric), and evidence of relationship with other variables, specifically the difference in scores between experts and students. A convenience sample of third-year students who had never performed equine castration (n = 24) and veterinarians who had performed equine castration (n = 25) performed surgery on the model while being video recorded. Participants completed a post-operative survey about the model. All veterinarians (100%) agreed or strongly agreed that the model was suitable for teaching students the steps to perform equine castration and for assessing students' skill. The checklist produced scores with good internal consistency (α = 0.805). Veterinarians performed the castration faster than the students (p = .036) and achieved a higher total global rating score (p = .003). There was no significant difference between groups in total checklist score or individual checklist items, except veterinarians were more likely to check both sides for bleeding (p = .038). The equine castration model and rubric validated in this study can be used in a low-stress clinical skills environment to improve students' skills to perform what is otherwise a challenging field procedure. Model use should be followed with live animal practice to complete the learning process.

The construction of canine distal limb models used in teaching sonography identification of vegetal foreign bodies

Musculoskeletal ultrasonography is a useful tool to identify radiolucent vegetal foreign bodies (VFBs). However, limited ultrasound experience and unfamiliarity with the normal sonographic appearance of anatomical structures can decrease clinician confidence. This study aimed to design a reusable silicone model that can teach VFB identification within the canine distal limb. Four canine hindlimbs were used to design the silicone models, and 12 canine distal forelimbs were constructed. The model was constructed using cadaver bones, barley grass (Avena fatua) seeds, and silicone to mimic the anatomy of the canine distal limb with a grass seed VFB. Limbs were randomly grouped based on grass seed locations: (1) the interdigital webbing, (2) the palmar surface of the canine forelimb immediately proximal to the metacarpal pad, (3) the dorsal surface of the distal limb immediately proximal to the proximal phalange, or (4) no grass seed (control) placed. Each limb was systematically ultrasounded and compared with cadaver limbs and clinical VFB cases. A comparison of ultrasonographic images validated the construction, revealing that the simulation model replicates the anatomical and echotexture characteristics of the normal canine distal limb. Furthermore, these models also have a likeness to clinical canine distal limb VFB cases and can be utilized as a training tool.

Development and Evaluation of a Surgical Simulator and Assessment Rubric for Standing Castration of the Horse

In veterinary education, simulators are models or devices that can imitate a real patient or scenario and allow students to practice skills without the need for live patients. Castration is a common surgical procedure in all species, and the standing, open technique is frequently performed in horses. Although a simulator has been developed for equine closed castration, a simulator for standing castration in the horse has not yet been described. This two-part study focused on the design, creation, and evaluation of a simulator for teaching standing castration in the horse. A low-technology simulator was created using molded silicone testicles, cohesive bandage, stockings, and socks. A rubric was created for assessing performance using the simulator. Participants were recruited from three groups: university academic staff members (n = 12, majority equine veterinarians), equine veterinarians working in private practice (n = 9), and final-year veterinary students (n = 28). Each group tested the simulator while being graded using the developed rubric, and participants completed an anonymous online feedback questionnaire. Feedback was positive overall, with 98% of respondents (n = 48/49) stating that the model would be a useful addition to the veterinary curriculum. Furthermore, 100% of students reported that using the simulator increased their confidence in performing standing castration in horses. Evaluation of the model included assessment of responses from veterinarians and students regarding realism and usefulness of the simulator, comparison of rubric scores between veterinarians and students, and assessment of the reliability of the rubric. Median student rubric score was significantly lower than qualified veterinarians (p < .001), and Cronbach's alpha demonstrated that there was adequate internal reliability in rubric scoring (α = .85). It was determined that the simulator is effective for teaching the steps of the surgical procedure and for increasing student confidence.

Attitudes, Experience, and Self-Confidence of Veterinary and Veterinary Nursing Students in Small Animal Dentistry: A Survey Study

Dental issues are extremely common in dogs and cats, underscoring the importance of veterinary professionals' knowledge in dentistry. Nevertheless, dental problems are currently often underdiagnosed and, consequently, undertreated. This study investigated the attitudes, experiences, and self-confidence of veterinary (V) and veterinary nursing (VN) students in their final two years of study in small animal dentistry. An online questionnaire was distributed, and responses were received from 61% of V students (n = 94) and 41% of VN students (n = 72). The majority of both V students (61%) and VN students (69%) expressed a desire for more education in small animal dentistry. Furthermore, a minority of V students (20%) and VN students (22%) felt adequately prepared for their first day in practice after graduation. Less than half of the students (V 44% and VN 38%) had participated in a practical dental procedure outside training sessions. Self-confidence in small animal dentistry procedures was rated on a 0-10 scale. V students exhibited the highest confidence in teeth polishing (6.1) and removing tartar with ultrasonic scalers (6.0), while VN students were most confident in recognizing common oral/dental problems (6.0) and discussing dental issues with pet owners (5.3). Extra practical training significantly increased confidence in several dental procedures (p < .005). Despite positive attitudes, a notable proportion of V and VN students feel unprepared for their first day in practice, potentially stemming from insufficient training. Addressing these gaps through clear guidelines for Day One Competence and enhanced practical training is crucial, ultimately benefiting the well-being of small animals.

Development and Integration of Models for Teaching Ram Breeding Soundness Examinations in Veterinary Education

Proficiency with ram breeding soundness examinations requires competency with palpation, a skill that can be difficult to teach and assess. There are limited small ruminant clinical skills models available, despite the advantages they offer in veterinary education. We developed reusable models for teaching ram breeding soundness examinations, focusing on scrotal assessment and palpation. Then we integrated these models into a practical session where multiple clinical aspects were included. We created anatomically normal ("sound") testes using 3D modeling software before editing these to display common abnormalities ("unsound" testes). Then, we 3D printed two-part molds and cast the silicone testes. Testes were inserted into siliconized, lubricated stockings facilitating free movement during palpation. Scrotal sacs were sewn from polar fleece and suspended to mimic natural orientation in a live, standing ram. As well as for scheduled classes, we used the models as a station in our course's Objective Structured Clinical Examination (OSCE) assessment. Our models offer advantages in the veterinary education context. Their relatively low cost and durability facilitates their classification as "open access" within our skills lab for student deliberate practice outside scheduled classes. They provide a uniform student learning experience that does not rely on live animals or clinical case load and aligns with best-practice recommendations from accrediting bodies. Student engagement and OSCE outcomes were good, but going forward it would be ideal to collaborate with a program that uses live rams for teaching and assessing this skill to directly examine the impact of our models on confidence and competence.

Trained to cut? A literature review of veterinary surgical resident training

A surgical residency trains veterinary graduates to a higher level of expertise in surgical procedures than is possible during veterinary school and prepares a resident to pursue board certification in surgery. The education of veterinary surgical residents has changed minimally since its inception in the twentieth century, and there are insufficient studies to determine if residency programs are producing surgeons with competence in each of the necessary procedural categories. The aims of this review were to report the current theory and methods used to provide surgical education to residents, to discuss the training most likely to create a competent, board-certified surgeon and to review assessment methods used during training. Several literature searches using broad terms such as "veterinary surgery residency," "veterinary surgery resident," and "veterinary surgical training" were performed using PubMed, CAB abstracts, and Google Scholar. Literature pertinent to theory, methods, training, and assessment of veterinary surgical residents was included. The reviewed literature demonstrated the need for research-based learning curves for specific procedures. Simulation training is known to facilitate deliberate practice and should be leveraged where possible to reach competency. The creation of validated assessment methods should be pursued as it enables assessment of competency instead of inferring its development from case logs. Understanding and supporting learner cognition and providing sufficient feedback remain important issues in the field. Surgical educators are urged to continue to search for innovative and evidence-based ways to train competent surgical residents.

The Rapid and International Expansion of Veterinary Clinical Skills Laboratories: A Survey to Establish Recent Developments

Veterinary clinical skills laboratories are used for teaching a wide range of practical, clinical, and surgical skills on models and simulators. A survey conducted in 2015 identified the role of such facilities in veterinary education in North America and Europe. The current study aimed to capture recent changes using a similar survey with three sections to collect data about the structure of the facility, its uses in teaching and assessment, and the staffing. The survey consisted of multiple choice and free text questions, was administered online using Qualtrics and was disseminated in 2021 via clinical skills networks and Associate Deans. Responses were received from 91 veterinary colleges in 34 countries; 68 had an existing clinical skills laboratory and 23 were planning to open one within 1-2 years. Collated information from the quantitative data described the facility, teaching, assessment, and staffing. Major themes emerged from the qualitative data relating to aspects of the layout, location, integration in the curriculum, contributions to student learning, and the team managing and supporting the facility. Challenges were associated with budgeting, the ongoing need for expansion and leadership of the program. In summary, veterinary clinical skills laboratories are increasingly common around the world and the contributions to student learning and animal welfare were well recognized. The information about existing and planned laboratories and the tips from those managing the facilities provides valuable guidance for anyone intending to open or expand an existing clinical skills laboratory.

Simulating Ovariohysterectomy: What Type of Practice Promotes Short- and Long-Term Skills Retention?

Simulation-based surgical training allows students to learn skills through deliberate practice without the patient risk and stress of operating on a live animal. This study sought to determine the ideal distribution of training sessions to improve short- and long-term retention of the skills necessary to perform a simulated ovariohysterectomy (OVH). Fourth-semester students (n = 102) were enrolled. Students in the weekly instruction group (n = 57) completed 10 hours of training on the OVH simulator, with sessions held at approximately weekly intervals. Students in the monthly instruction group (n = 45) completed the same training with approximately monthly sessions. All students were assessed 1 week (short-term retention test) and 5 months following the last training session (long-term retention test). Students in the weekly instruction group scored higher on their short-term assessment than students in the monthly instruction group (p < .001). However, students' scores in the weekly instruction group underwent a significant decrease between their short- and long-term assessments (p < .001), while the monthly group did not experience a decrease in scores (p < .001). There was no difference in long-term assessment scores between weekly and monthly instruction groups. These findings suggest that if educators are seeking maximal performance at a single time point, scheduling instructional sessions on a weekly basis prior to that time would be superior to monthly sessions, but if educators are concerned with long-term retention of skills, scheduling sessions on either a weekly or monthly basis would accomplish that purpose.

Establishing the Most Important Clinical Skills for New Graduate Veterinarians by Comparing Published Lists with Regional Stakeholder Expectations: A Bangladesh Experience

Veterinary clinical skills training is evolving rapidly around the world and there is increasing interest in Bangladesh in opening clinical skills laboratories and using models in teaching. The first clinical skills laboratory was opened at Chattogram Veterinary and Animal Sciences University in 2019. The current study aimed to identify the most important clinical skills for veterinarians in Bangladesh to inform the further development of clinical skills laboratories and ensure resources are deployed effectively and efficiently. Lists of clinical skills were collated from the literature, national and international accreditation standards, and regional syllabi. The list was refined through local consultation, focused on farm and pet animals, and was disseminated via an online survey to veterinarians and final-year students who were asked to rate the level of importance of each skill for a new graduate. The survey was completed by 215 veterinarians and 115 students. A ranked list was generated with injection techniques, animal handling, clinical examination, and basic surgical skills among the most important. Some techniques requiring specific equipment and some advanced surgical procedures were considered less important. As a result of the study, the most important clinical skills for a new graduate in Bangladesh have been identified for the first time. The results will inform the development of models, the use of clinical skills laboratories, and the design of clinical skills courses for veterinary training. Our approach of drawing upon existing lists followed by local stakeholders consultation is recommended to others to ensure clinical skills teaching is regionally relevant.

Evaluation of an Equine Nasogastric Intubation Model for Training Veterinary Students

Simulation in veterinary education is an important means of providing a safe, welfare-friendly way for students to hone their skills prior to performing procedures on live animals. Students may not get many chances to practice passing a nasogastric tube and checking for reflux in live horses during clinical rotations and extramural studies. A low-cost equine nasogastric intubation model was created at the University of Surrey, allowing students to practice passing a tube and checking for reflux. Thirty-two equine veterinarians evaluated the model for realism and its potential usefulness in teaching. Veterinarians found the model to be realistic, supported its use as a teaching aid, and provided helpful feedback for possible improvements. In addition, 83 year-4 veterinary students rated their level of confidence before and after using the model for nine specific aspects of nasogastric intubation. Students showed significantly increased confidence levels in all nine aspects after using the model, and reported that they appreciated being able to practice the skill in a safe environment prior to performing it on a live horse. The results of this study suggest that both clinicians and students considered that this model has educational value, which supports its use for training veterinary students prior to clinical placements. The model provides an affordable, robust educational aid that can be used in clinical skills teaching, increases student confidence, and allows students to practice the skill repeatedly.

Evaluation of anesthetic skills acquisition in pre-graduate veterinary students with different grades of anesthetic experience using veterinary simulation exercises

Background

Anesthetic skills are usually learned through continuous supervision by experienced trainers who observe, advise and challenge students. Current educational techniques rely less on live animal training and include the use of simulations and models for teaching and assessment of surgical and anesthetic skills.

Objective

To evaluate the development of anesthetic skills of veterinary students having different levels of previous experience using simulation. An additional aim was to evaluate the impact of the simulation training on students with no anesthesia experience.

Study design

Single group periinterventional and postinterventional study.

Methods

Initial and final anesthesia simulation training recording were obtained from 53 randomly selected veterinary students. Seven faculty members blinded to previous student anesthesia experience reviewed the simulation recording and scored student performance using a rubric, results were recorded and analyzed.

Results

All students participating in an anesthesia and surgery course reached higher proficiency levels on fundamental anesthesia skills regardless of their previous amount of experience with anesthesia. Simulation based learning positively influenced the final score in veterinary students having no previous anesthesia training, suggesting that it is possible for veterinary students to achieve a level of competence in anesthesia skills with simulation-based training.

Main limitations

Sample size, group simulation, multiple reviewers bias.

Conclusion

Students having no experience with clinical anesthesia demonstrated remarkable improvement in their skills, achieving a score that was similar to students having extensive prior clinical anesthesia experience. Despite this clear improvement students having no prior clinical anesthesia experience required more time to complete all anesthesia tasks and may require more training sessions to acquire the speed demonstrated by peers who had significant prior clinical anesthesia experience. Overall, all participants reached a higher proficiency level performing fundamental anesthesia skills at the end of the course.

Approaches to Laparoscopic Training in Veterinary Medicine: A Review of Personalized Simulators

Veterinary minimally invasive surgery (MIS) has experienced notable growth in recent years, yet the availability of specialized training tools remains limited and not readily accessible to practitioners worldwide. While borrowing simulators from human medicine practices suffices for acquiring fundamental laparoscopic skills, it proves inadequate when addressing procedure-specific nuances. Veterinary professionals are now taking steps to create simulators tailored to their patients, although the validation process can be time-consuming. Consequently, the availability of advanced laparoscopic simulators for veterinary training remains scarce. The present study aims to highlight custom-made simulators. A comprehensive search across five databases was conducted to uncover the simulators documented from 2010 to 2022. A total of five simulators emerged from this search, with four grounded in a canine model and only one in an equine model. These models underwent validation and were found to be effective in training surgeons for their designated tasks. The findings underscore a limited array of simulators, predominantly catering to two species (horses and dogs). Considering these findings, it is evident that further research is imperative to create laparoscopic simulators capable of facilitating advanced veterinary training. This would enable the continued evolution of surgical techniques across diverse species, including ruminants, small mammals, and non-mammalian animals.

Use of a Composed Simulator by Veterinarian Non-Experts in Minimally Invasive Surgery for Training and Acquisition of Surgical Skills for Laparoscopic Ovariectomy in Dogs

This study aims to assess the acquisition of surgical skills for laparoscopic ovariectomy (LOE) in dogs by veterinary surgeons with no experience in minimally invasive surgery using the CALMA Veterinary Lap-trainer simulator (CVLTS) in an experimental and analytical setting. Veterinary surgeons with no experience in minimally invasive surgery (MIS) (experimental, n = 5), and MIS experts (experts, n = 3) were evaluated. Experimental and expert group participants watched an instructional video (initial time) before practicing the LOE on uterine tissues and ovaries freshly reconstituted after elective ovariohysterectomy (initial time evaluation). Then, the experimental group practiced five training sessions on the composite simulator with permanent feedback and then performed the LOE again (final time evaluation). Surgical performances in initial and final evaluations were video recorded and further evaluated by three external MIS experts using Global objective assessment of laparoscopic skills (GOALS) and LOE-specific rating scales (SRSs) in a double-blinded schedule. In addition, a hands movement assessment system (HMAS) attached to the back of the hands was used to quantitatively measure completion time, angularity, and movement smoothness. Data were analyzed with one-factor ANOVA and Tukey's contrast test. No statistically significant differences were found between the novice group's performance after training and the expert group's performance according to the GOALS (p < 0.01) and SRS (p < 0.05) scores. Moreover, the novices had significantly improved time, number of movements, and angularity in the final time compared with the initial time (p < 0.05), with no significant differences compared to the expert group (p > 0.05). LOE training using a composed simulator resulted in significantly improved laparoscopic skills and time, number, and angularity of movements data, providing evidence of the usefulness and reliability of CVLTS in training LOE.

Jean K, Gingerich W, Abramo N, Stahl D, Walters C, Artemiou E. The Evaluation of a High-Fidelity Simulation Model and Video Instruction Used to Teach Canine Dental Skills to Pre-Clinical Veterinary Students

In recent years, there has been an increased focus on the teaching of small-animal dentistry to veterinary students in order to address the recognized gap between dental skill training and the expectations of employers regarding the competencies of new graduates in this field. In this study, third-year veterinary students were trained in three canine dental core skills using either a high-fidelity model (Group A) or video instruction (Group B). An objective structured clinical examination was used to assess skill acquisition and questionnaires were distributed in order to assess student confidence and perceptions related to small-animal dentistry practice and related skills before and after the training. All results were compared between the two groups. Group A outperformed Group B in skill acquisition (p < 0.001) and there was greater improvement in skill confidence for Group A than Group B (p < 0.001). There was no statistical difference in perceptions related to small-animal dentistry between the two groups after the training (p ≥ 0.1). Group A rated their training experience more highly than Group B (p < 0.001). Although dental skill acquisition shows greater improvement when training is provided by models rather than video instruction, a blended approach to teaching dental skills is likely to be the best approach to optimizing dental skill acquisition.

Evaluation of veterinary students' confidence and competence with surgical entrustable professional activities after repeated use of low-fidelity training models

BACKGROUND

This study aimed to evaluate whether low-fidelity surgical training models increased veterinary students' surgical confidence and competence and decreased procedural stress related to core surgical entrustable professional activities (EPAs).

METHODS

Final-year veterinary students repeatedly performed one of three surgical EPAs on a low-fidelity surgical training model (canine castration, subcutaneous lump removal and eyelid laceration repair) and completed a survey at set time points. In addition, a grading rubric was used to assess participants' competence in performing the assigned EPA at two different time points. Survey results and competency gradings were compiled and analysed.

RESULTS

Students' self-assessed confidence significantly increased, and stress significantly decreased, between assessment points on all three EPA surgical training models. Graded competence significantly improved between the assessment points on all training models, and most students deemed the models to be realistic and helpful for student practices.

LIMITATIONS

Limitations relate to the study involving a single cohort from a single institute and the reliance on student self-assessment.

CONCLUSIONS

Repeated exposure to low-fidelity surgical training models increased final-year students' surgical confidence and competence and reduced procedural stress related to three key surgical EPAs. Assessment of competence using a grading rubric was successful and could be incorporated into a competence-based veterinary education assessment framework to allow screening of competence prior to graduation.

The Impact of the COVID-19 Pandemic on Veterinary Clinical and Professional Skills Teaching Delivery and Assessment Format

The limitations posed by the COVID-19 pandemic have been particularly challenging for courses teaching clinical and professional skills. We sought to identify how the COVID-19 pandemic has impacted the delivery of veterinary clinical and professional skills courses, including modifications to teaching and assessment, and to establish educators' perceptions of the efficacy of selected delivery methods. A branching survey was deployed to 35 veterinary schools in North America in March and April 2021. The survey collected data about curriculum and assessment in spring 2020, fall 2020, and spring 2021. Educators at 16 veterinary schools completed the survey (response rate: 46%). Educators quickly adapted curriculum to meet the requirements of their institutions and governments. Early in the pandemic (spring 2020), curriculum was delayed, delivered remotely, or canceled. Assessment methods frequently included virtual objective structured clinical examinations (OSCEs) and video-recorded skills assessments. Later in the pandemic (fall 2020, spring 2021), in-person clinical skills sessions resumed at many schools, often in smaller groups. Professional skills instruction typically remained virtual, as benefits were noted. Assessment methods began to normalize with in-person OSCEs resuming with precautions, though some schools maintained virtual assessments. Educators noted some advantages to instructional methods used during COVID, including smaller group sizes, better prepared students, better use of in-person lab time, more focus on essential course components, provision of models for at-home practice, and additional educators' remote involvement. Following the pandemic, educators should consider retaining some of these changes while pursuing further advancements, including improving virtual platforms and relevant technologies.

Innovative models for teaching reproduction in small animals: The experience at DIMEVET of Bologna University

For a long time, the main way to acquire the skills necessary for good veterinary practice has been the traditional apprenticeship model (observe, assist, and perform under supervision). However, in the last years, more creative and innovative teaching models have been adopted by academic institutions and, parallelly, the opportunities to gain hands-on experience for clinical and surgical procedures are becoming more limited. For that reason, the introduction of the models can provide a potential solution to the ethical and legal implications related to the use of live animals for educational purposes and the biosafety risks deriving from the manipulation of human/animal cadavers. The activity on this topic at DIMEVET and, in particular, the experience about teaching reproduction includes in-house production and use of models for learning skills both for degree (fifth and third years of course) and post-graduate courses. Our models are designed on the basis of two fundamental aspect: the student level and the teacher target. The aim of this study was to evaluate, for the first time in literature, how much the use of simulators impacts on practical teaching in degrees and post graduate courses at DIMEVET, considering different learners with different levels of knowledge and skills. Namely, effectiveness, adequacy and quality of simulators have been checked assessing students' learning experience and teacher's opinion by specific satisfaction questionnaires and considering the attendance at the training sessions and the results of a final examination (PHY group) and an in vivo test (POST group). The rate of satisfaction was high among the three groups considered and the participants that had used the models had a higher success, both in the final examination and in vivo test. Data collected have been useful in order to show an improvement in teaching at DIMEVET in the field of reproduction, despite the relatively short years of experience using simulation. With this study we demonstrate that the adequacy of the models is not correlated to how simulators is built, whether with basic materials or not faithfully in terms of anatomical appearance, but it is important that it is realistic in terms of psychomotor procedure. In conclusion, the use of models permits the student to gain the hand-eye coordination and dexterity necessary to perform certain skills and the models proposed are meeting the desired educational goals.

Validation of a Rubric Used for Skills-Based Assessment of Veterinary Students Performing Simulated Ovariohysterectomy on a Model

Surgical skills are an important competency for new graduates. Simulators offer a means to train and assess veterinary students prior to their first surgical performance. A simulated ovariohysterectomy (OVH) rubric's validity was evaluated using a framework of content evidence, internal structure evidence, and evidence of relationship with other variables, specifically subsequent live surgical performance. Clinically experienced veterinarians (n = 13) evaluated the utility of each rubric item to collect evidence; each item's content validity index was calculated to determine its inclusion in the final rubric. After skills training, veterinary students (n = 57) were assessed using the OVH model rubric in March and August. Internal structure evidence was collected by video-recording 14 students' mock surgeries, each assessed by all five raters to calculate inter-rater reliability. Relationship with other variables evidence was collected by assessing 22 students performing their first live canine OVH in November. Experienced veterinarians included 22 items in the final rubric. The rubric generated scores with good to excellent internal consistency; inter-rater reliability was fair. Students' performance on the March model assessment was moderately correlated with their live surgical performance (ρ = 0.43) and moderately negatively correlated with their live surgical time (ρ = -0.42). Students' performance on the August model assessment, after a summer without surgical skills practice, was weakly correlated with their live surgical performance (ρ = 0.17). These data support validation of the simulated OVH rubric. The continued development of validated assessment instruments is critical as veterinary medicine seeks to become competency based.

The Use of Simulators for Teaching Practical Clinical Skills to Veterinary Students - A Review

In the context of veterinary education, simulators are devices or sets of conditions aiming to imitate real patients and enable students to practice skills without the need for live animal use. Simulator use in veterinary education has increased significantly in recent years, allowing consistent practical teaching without reliance on clinical cases. This review examines the available literature regarding the use of simulation and simulators for teaching practical day one competences to veterinary students. Scientific databases were searched and 73 relevant articles were reviewed. The reviewed articles revealed that there are a number of simulators currently available to veterinary educators, that simulators can enhance student skills and provide an alternative learning environment without the need for live animal and/or cadaver use, and that they usually receive positive feedback from the students who use them. There appears to be a bias towards small animal simulators - however, some skills that are developed through the use of small animal or table-top models will be transferrable to other species. The majority of large animal simulators focus on bovine rectal palpation and/or pregnancy diagnosis. Further research is required to increase the repertoire of available simulators for use in veterinary education, in order to improve the practical skills of veterinary students and reduce the use of live animals and cadaver material for teaching purposes.

What's the evidence? A review of current instruction and assessment in veterinary surgical education

Veterinary surgical education is improved by studying the relevant literature. The aim of this literature review was to report the theory and methods used to provide surgical education to veterinary students; to discuss the training most likely to create a competent general practitioner; and to review assessment methods for simulated and live surgeries. The literature reviewed demonstrates that new graduates are expected to perform small animal sterilization, dental extraction, onychectomy, abscess treatment, aural hematoma repair, and mass removal with little or no supervision. Students require repetitive practice to reach competence; some practice can take place in a clinical skills laboratory on models or cadavers. When training novices, distributing practice over a longer time improves retention, but months without practice causes skills to decay. Suturing skills may be taught on models at a ratio of 1 instructor per 10 students. Veterinary students require 6-10 repetitions of each small animal sterilization surgery to reach competence; however, learning curves for other surgeries have not been established. Assessment of surgical skills has been undertaken using objective structured clinical examinations (OSCEs) and observed model and live surgeries. Additional validated rubrics are needed in the field. Surgical educators are urged to continue to search for innovative ways to foster deliberate practice, assess skill, and provide feedback for students.